New in PCOS therapy!
Chirofol® 500 is a natural preparation with no side effects, so with the use of 1 tablet a day you can only gain benefits for yourself and your body.
D-Chiro-Inositol, folic acid, vitamin B12, manganese
20 gastro-resistant tablets
What is PCOS?
Polycystic ovary syndrom – Symptomatology and diagnosi
Polycystic ovary syndrome is a disease that was initially discovered in the first half of the 20th century. The disease was first described by scientists Stein and Leventhal in 1935, who stated disorderly bleeding, increased hairiness (hirsutism), obesity and infertility as the main characteristics of the disease.
Today, polycystic ovary syndrome (PCOS) is one of the most common hormonal diseases that affect women during puberty and menopause. It is considered that between 5 and 10 percent of women in the reproductive period have polycystic ovaries. It is estimated that over 80,000 women suffer from this disease in Serbia today.
Frequency of symptoms
More about PCOS:
Diagnosis of PCOS
Absence of menstruation or irregular menstruation should already be sufficient reason to visit a doctor. Based on these and other symptoms of the disease and with the help of additional laboratory and ultrasound examinations, the doctor can diagnose PCOS. For the final diagnosis, doctors most often use the so-called Rotterdam criteria where two out of three criteria should be fulfilled to diagnose PCOS. The criteria are as follows:
- Ultrasound-confirmed polycystic ovaries
- Oligo or anovulation
- Clinical or biochemical hyperandrogenism
In laboratory examinations we most often detect: high insulin levels (hyperinsulinemia), lipid status disorders (increased triglycerides and decreased HDL), and elevated levels of male hormones.
Ultrasound is a very important method that helps diagnose PCOS today. Ultrasound usually shows a classic image of this syndrome as a series of “pearls” along the ovary, so you can see a large number of cysts, interconnected, that can be between 2 and 10 mm in size. Even though we live in the era of modern technology and advanced diagnostic methods, somewhere around 40% of women remain without an accurate diagnosis.
PCOS and insulin resistance
Insulin resistance is a condition in which our cells are insensitive to the action of insulin, a hormone extremely important for metabolism of sugars (burning, storage), lipids, and other important compounds. For insulin to function as a hormone, the activity of certain “messengers”, which are activated by binding insulin to its receptors, is required. One of those messengers is D-chiro-inositol, without sufficient amount of which there is no cell response to insulin action, leading to chronic hyperglycemia (increased blood sugar) and consequently chronically high blood insulin levels.
The condition of insulin resistance may be maintained for a certain period, but with increasing depletion of pancreatic cells (which produce insulin), the development of type II diabetes mellitus occurs over time. Type II diabetes is a condition that carries with it a number of not so harmless changes in our body (impaired kidney function, increased risk of atherosclerosis, retinopathy, neuropathy…)
Therefore, we should do everything in our power to prevent the progression of insulin resistance!
PCOS therapy is chronic and should be administered for many years along with regular medical check-ups. PCOS therapy should be targeted, depending primarily on the age of the woman and what is her priority.
For these reasons, we can define categories as follows:
1. Women with PCOS who do not want pregnancy:
So far oral contraceptives have been available to physicians for PCOS therapy in this group of women. Oral contraceptives have helped regulate hormones but have no effect on the metabolism and regulation of hyperinsulinemia.
With the advent of CHIROFOL® tablets, a new therapeutic opportunity has emerged which besides the use of oral contraceptives that will prevent pregnancy include the use of CHIROFOL® which will reduce insulin resistance. Therefore, this group of women with PCOS is advised to receive the following therapy: CHIROFOL® plus oral contraceptives. CHIROFOL® will improve metabolic status, reduce insulin resistance, testosterone levels, reduce hirsutism. Oral contraceptives will improve hormonal balance and prevent conception.
2. Women with PCOS who want pregnancy
CHIROFOL® tablets have created a new therapeutic option for the therapy in patients with PCOS, as they improve the cell’s sensitivity to insulin resistance and thus improve the symptoms of the disease. CHIROFOL® is a completely natural preparation and has no side effects, so it can be taken over a long period of time without any restrictions. CHIROFOL®establishes ovulation and restores hormonal balance, regulates the menstrual cycle, decreases insulin resistance, reduces hyperandrogenism, reduces hirsutism and acne. So, women who have PCOS and want to get pregnant now may be recommended CHIROFOL® as a new completely natural therapy, with no side effects.
3. Women with PCOS who are in an IVF program:
The following therapy is recommended for this group: CHIROFOL® plus additional therapy prescribed by the IVF program. CHIROFOL® tablets therapy lasts for 3 months before the stimulation phase and during treatment/pregnancy. CHIROFOL® restores spontaneous ovulation, has a pronounced antioxidant effect and improves oocytes quality.
PCOS & Lifestyle
As we have repeatedly noted in the background of PCOS, as many as 70% of women have hyperinsulinemia as the root cause of the disease, and obesity is a common consequence in almost 40% of cases. Also, these patients are at increased cardiovascular risk and the potential for developing type II Diabetes Mellitus.
From all of the above, it can be clearly concluded that, in addition to therapeutic measures prescribed by physicians, changing life habits or lifestyle can have a significant positive effect on the outcome of therapy. Therefore, we can safely say that physical activity, diet and lifestyle change are not only preventative but also a therapeutic agent.
PCOS and DIET
The importance of diet in patients with PCOS is extremely high and aims to reduce body weight and improve cell sensitivity to insulin.
Many studies have shown a positive effect of diet on the therapeutic outcome with PCOS, and in less severe cases, diet with physical activity may be the first therapeutic measure.
There is no clearly defined diet related to PCOS, but there is general consensus on what types of diets may be beneficial for these patients. As PCOS is a complex disease, it is advisable to consult with a nutritionist who will prepare the most effective diet according to the individual needs of the organism.
Below we will give a brief overview of the diets most commonly recommended in patients with PCOS, but we think it is very important to note that diet should not be seen as a shorter life span in which we change our diet, but instead diet should become part of our daily lifestyle, and therefore it should be adjusted to our capabilities and needs, because only in this way it will give full effect, positively influence the therapy and progression of the disease and significantly improve our quality of life.
The DASH diet was originally intended to regulate blood pressure, fat and sugar. The very name of the diet is an acronym for Dietary Approaches to Stop Hypertension. In addition to normalizing blood pressure, fats and sugar levels, most people who have followed the DASH diet have noticed that they have an abundance of good energy and a significant improvement in the appearance of skin, hair and nails, so the diet has been used in other chronic conditions.
The DASH diet is divided into 2 phases:
- The first phase of the DASH diet is restrictive, lasts for two weeks and during this period carbohydrate intake is significantly reduced. At this stage of the DASH diet it is forbidden to eat fruits, sweets and all sources of sugar, as well as cereals. The diet is based on lean meat and fish, non-starchy vegetables, non-fat dairy products and nuts. The aim of this phase is to improve metabolism and reduce fat deposits.
- The second phase in the DASH regime allows the gradual inclusion of fruits, whole grains and all vegetables in the diet. Weight loss continues at this phase, but at a slower pace than the first phase. This phase can last for the rest of your life.
In both phases, it is very important that you have three basic meals – breakfast, lunch and dinner and you should never skip them. If you get hungry between meals, two snacks are allowed when you can eat seeds or vegetables.
The amount of food that is desirable to eat during a meal should be moderate, except for vegetables that can be eaten in unlimited quantities.
The goal of this diet is to use foods that will not lead to a greater increase in insulin levels in the body, so for these reasons, foods that have a low GI (below 55) are recommended.
Foods with low GI values are slowly digested and absorbed and this group of foods includes the following:
- Integral cereals, rye, oatmeal, bran, quinoa, barley, buckwheat.
- Long grain rice and brown rice.
- Regarding fruits, apple, strawberry, apricot, peach, plum, pear and kiwi.
- Vegetables: tomatoes, carrots, zucchini, broccoli, cauliflower and celery.
- Vegetables containing starch: sweet potatoes, corn.
- Legumes: lentils, beans, peas.
- Dairy products: milk, cheese, yogurt, soy milk, almond milk.
- Meat: beef, chicken, lamb, pork. Eggs.
- Fish: salmon, trout, tuna, sardines
- Nuts: walnuts, almonds, cashew nuts, pistachios.
- Fats and oils: olive oil, butter and margarine.
- Herbs and spices: salt, pepper, garlic, basil.
So in a low GI diet one does not have to determine the portion size or the optimal number of calories, carbohydrates or fat to lose or maintain weight. The essence of this diet is to replace high GI carbohydrates with foods that contain low GI carbs.
An anti-inflammatory diet is often recommended in patients with chronic illnesses such as allergies, arthritis, inflammatory bowel diseases, diabetes, asthma, PCOS… etc.
The goal of this diet is to reduce the level of chronic inflammatory process which is often associated with said chronic diseases, through nutrition, while also ensuring the intake of all the necessary nutrients and contributing to the optimal health of the body.
Foods recommended in anti-inflammatory diets:
- Fish: salmon, herring, mackerel, sardines
- Eggs, milk and olive oil
- Integral cereals: black bread, cooked wheat, integral oatmeal.
- Fruits: raspberries, blackberries, strawberries, blueberries, cherries, apples.
- Vegetables: tomato, kale, spinach, beans, peppers, beets.
- Brown rice
- Nuts: walnuts, hazelnuts, almonds.
- Dark chocolate (with at least 70% of cocoa).
- Spices: garlic, ginger, turmeric.
The Keto or ketogenic diet is designed to include consuming foods with a high percentage of fat and very low carbohydrate content. Ketosis is a natural process triggered by the body when you get hungry. During this process, we produce ketones, which result from the breakdown of fat in the liver. The keto diet aims to bring the body into this specific metabolic state, not by starvation, but by reducing carbohydrate intake.
Foods recommended in the Keto diet:
- Meat and eggs – fish, beef, lamb, poultry.
- Vegetables – spinach, kale, cabbage, broccoli, cauliflower.
- High-fat dairy products – kajmak (milk cream), cheese, butter.
- Nuts and seeds – walnuts, sunflower seeds.
- Avocados and berries – raspberries, blueberries and other berries that have lower influence on the glycemic index.
- Sweeteners – stevia, erythritol.
- Other fatty foods – coconut oil, sauces and dips for salads, saturated fats, etc.
Nutrient intake structure should consist of about 70% fat, 25% protein and 5% carbohydrates (20-30g daily).
A low-calorie diet involves consuming 1000 to 1500 calories a day. This creates a calorie deficit that leads to weight loss. It can be effective, but implementing it also requires a great deal of discipline.
The basic rule of this diet is that we have five small meals throughout the day. Namely, in this way you get a sense of satiety, and at the same time you intake minimal amounts of calories.
Diet involves mainly the intake of meat, fish, eggs, green vegetables, oils, as well as dairy products. In minimal quantities, butter and cheese intake is allowed while carbohydrate intake is restricted.
Ideally, you should seek help from a nutritionist or doctor so as not to over-restrict calories or miss out on essential nutrients.
Conducting a diet without physical activity makes almost no sense and vice versa, the diet accompanied by physical activity provides a true synergistic effect and speeds up the process of rehabilitation of the body. The effects of physical activity on PCOS are: improvement of insulin sensitivity, repair of ovulatory cycles, reduction of cholesterol, improvement of physical fitness.
Many experts agree that at least 150 minutes of exercise a week is ideal. Best results are achieved when combining aerobic activity and strength training.
Recommended aerobic activities include fast running, jogging, cycling, swimming. The recommendation is a minimum of 30 minutes a day of moderate aerobic activity, for the most days of the week, or 3 days with 20-minutes intense activity.
Strength training is recommended 2 times a week and involves 8 to 12 exercises with weights that allow 10-15 reps per set.
In addition to physical activity, also are recommended a sufficient amount of sleep, smoking cessation, reduced amount of alcohol and as much stress avoidance as possible.
In this way, by accepting changes in life habits, we can significantly influence the course and prognosis of the disease.
D-hiro-Inozitol is a natural substance, normally present in our body and in small quantities in food.
In order for D-chiro-inositol to form in the cell, the activity of the epimerase enzyme is required, which produces D-chiro-inositol in adequate amounts from myoinositol. If epimerase function is inadequate (we deal with the genetic basis of PCOS), the formation of D-chiro-inositol is missing, and thus the cell’s response to the action of insulin is inadequate.
D-chiro-inositol is a significant insulin “messenger” in the cell, leading to the burning/storage of glucose in the cell, normalization of its blood level, and thus normalization of insulin levels. On this basis, the period of pancreatic beta cells “depletion” due to chronically high glucose levels and the risk of developing type II diabetes mellitus are reduced.
New in PCOS therapy!
CHIROFOL® is an innovative form of PCOS therapy. 500 mg of D-chiro-inositol normalizes glucose metabolism in the body, male sex hormone levels, ovulation, while folic acid and vitamin B12 are necessary for adequate preparation and normal fetal development during pregnancy.
- ESTABLISHES ovulation in women with PCOS
- RESTORES hormonal balance
- REDUCES insulin resistance and hyperandrogenism
- REDUCES hirsutism and acne
- REDUCES oxidative stress at the egg cell level
- SAFE – no side effects
CHIROFOL® is a natural preparation with no side effects, so with the use of 1 tablet a day you can only gain benefits for yourself and your body. The efficacy and safety of the product has been proven by numerous clinical studies that confirm that the use of CHIROFOL® leads to: improved ovulatory function, regulation of levels of insulin, male sex hormones, luteinizing and follicle-stimulating hormone and blood glucose, regulation of menstrual cycle, acne as well as antioxidant effect.
|CHIROFOL - 1 Tablet||Quantity||%RDI|
|Folic acid||200 mcg||100%|
|Vitamin B12||1,25 mcg||50%|
Gestational Diabetes Mellitus (GDM)
Gestational diabetes mellitus is a glucose intolerance condition that first occurs and is diagnosed in pregnancy.
It usually occurs between 24 and 28 weeks of gestation.
The risk factors for gestational diabetes are genetic predisposition (the existence of diabetes in the family), the age of the pregnant woman (pregnant women over 25 years of age are at higher risk), and overweight, obesity.
CHIROFOL® due to its mechanism of action, can prevent the development of GDM, and as a natural preparation it can be used safely during pregnancy in consultation with the doctor.
- Any fasting glycemia > 7 mmol/l, and glycemia at any time of day > 11,1 mmol/l.
- An oral glucose tolerance test (oGTT) should be performed.
- oGTT is usually performed with 100 grams of glucose for 3 hours.
- Glycemia values at the start of the test > 5.8; after 60 minutes > 10.6; after 120 minutes > 9.2; and after 180 minutes > 8.1 mmol/l indicate diabetes.
Complications of GDM
GDM carries with it certain complications for the mother such as: Spontaneous abortion and preterm birth, Preeclampsia – the appearance of high blood pressure as well as excess protein in the urine during pregnancy, usually after the twentieth week, and the occurrence of frequent infections.
On the other hand, during the course of GDM there is a possibility of developing complications that affect the fetus such as: Macrosomia (baby weighing 4000g), jaundice, impaired pulmonary function, congenital anomalies, intrauterine death, etc.
Efficacy has been demonstrated in a large number of clinical studies
CHIROFOL establishes normal ovulation in women with PCOS!5
CHIROFOL regulates hyperinsulinemia and hormone disbalance in women with PCOS (BMI > 26)!6
Statistically significant reduction of insulin level before and after the treatment.
Statistically significant increase of glucose/insulin ratio.
Statistically significant difference in the androstendione and testosterone levels before and after the CHIROFOL treatment.